Saturday, February 14, 2009

Drug Industry Wins Comparative Research Fight in Stimulus Bill

If you are looking for something to do over the weekend I suggest reading the one thousand page final stimulus bill.

You can access it here.

This past Wednesday, I posted the following regarding the differing health care comparative effectiveness research provisions in the House and Senate versions of the stimulus bill:
Comparative research--which drugs or medical devices work the best--makes a lot of sense. That is especially true in the wake of decades of research that continues to point to wide overuse of technology as the primary cost driver in our health care system.

So you would think this one was a no-brainer. But wait. From a Wall Street Journal story, "The drug industry is mobilizing to gut a provision in the stimulus bill that would spend $1 billion on research comparing medical treatments, portraying it as the first step to government rationing." And you know, these guys never lose.

The rub for the drug and device industry is that this kind of research could actually be able to call balls and strikes--which treatments don't work well and therefore should have their use subordinated to those that work better. Already, in the Senate version the industry has been successful in getting language that added the word "clinical" which has the effect of having any studies avoid "bang for the buck" kinds of conclusions.

One billion dollars for comparative research but we aren't allowed to know which drug or device gives us the best return for our money?
So, how was this resolved in the final bill?

From the "American Recovery and Reinvestment -- Conference Report," page 157 of Division A:
"That the funding appropriated in this paragraph shall be used to accelerate the development and dissemination of research assessing the comparative effectiveness of health care treatments and strategies through efforts that: (1) conduct, support, or synthesize research that compares clinical [emphasis added] outcomes effectiveness, appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, and other health conditions..."
Referring to the drug industry in my Wednesday post, I said, "And you know, these guys never lose."

Also, from Wednesday's post:
And, these were supposed to be the easy parts of health care reform. I am again reminded of all the reports in recent months about how different the 2009 version of health care reform will be with the special interests really ready to cooperate.
And some people think I'm cynical about health care reform.

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